Summary
 

Responsible for the accurate and timely processing of claims. This position is a full-time opportunity with an eight-hour shift, typically between the hours of 8:00 am to 5:00 pm EST, in a standard office environment.

Description
 

• Research and process claims according to business regulation, internal standards and processing guidelines.
• Verifies the coding of procedure and diagnosis codes.
• Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
• Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.
• Required Education:
• High School Diploma or equivalent
• Required Skills and Abilities:
• Strong analytical, organizational and customer service skills.
• Strong oral and written communication skills.
• Proficient spelling, punctuation, and grammar skills.
• Good judgment skills.
• Basic business math skills
• Required Software and Tools:
• Basic office equipment.
• Preferred Work Experience:
• 1 year-of experience in claims processing or customer service.
• Preferred Skills and Abilities:
• Proficient in Microsoft Office Products.
• Keyboarding/Typing and Data Entry skills.
• Ability to use complex mathematical calculations.
• Ability to use Microsoft Office (Outlook, Word, Excel, etc.) proficiently.
• A current C2 security clearance is highly desired. **If not currently held, the successful candidate must be able to obtain C2 Security clearance, once hired for the role.
• Preferred Software and Other Tools:
• Proficient in word processing and spreadsheet applications. Proficient in database software.
• Work Environment:
• Typical office environment.

 

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

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Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals and veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.